RESUMEN
BACKGROUND & AIMS: Cardiovascular diseases are the leading cause of mortality worldwide, originating in the first decades of life. A better understanding of their early determinants would allow for better prevention. This study aimed to evaluate the impact of nutritional and activity-related characteristics during adolescence on young adult cardiovascular risk factors. METHODS: The Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study included adolescents (aged 12.5-17.5 years) in 10 European centres. Four centres designed a nested cohort including 236 participants who were reassessed as young adults (21-32 years). Food consumption was evaluated by dietary recalls, physical activity by accelerometers, physical fitness using physical tests and nutritional knowledge by questionnaires. Cardiovascular health was assessed by Pathobiological Determinants of Atherosclerosis in Youth (PDAY) Study risk scores and its components. Factors associated with cardiovascular risk were identified using a multivariable regression model. RESULTS: Higher Diet Quality Index (DQI, P = 0.012) and nutritional knowledge (P = 0.015) were significantly associated with lower modified PDAY risk scores. Ultra-processed foods were associated with a lower non-high-density lipoprotein (non-HDL) cholesterol (P = 0.003), whereas DQI (P = 0.014) and Planetary Health Diet Index (P = 0.016) were associated with a higher HDL cholesterol. Higher DQI was also related to a lower body mass index (BMI, P = 0.006). In addition, cardiorespiratory fitness was related to a lower BMI (P = 0.004). CONCLUSIONS: Nutritional knowledge, diet quality and adherence to a sustainable diet in adolescence decrease cardiovascular risk in adulthood, whereas ultra-processed food consumption increases risk. These factors appear as targeted prevention tools for promoting a healthier adolescent lifestyle to decrease long-term cardiovascular risk. CLINICAL TRIAL REGISTRY NUMBER: Clinicaltrials.gov NCT02899416.
Asunto(s)
Enfermedades Cardiovasculares , Aptitud Física , Humanos , Adolescente , Masculino , Femenino , Enfermedades Cardiovasculares/prevención & control , Enfermedades Cardiovasculares/epidemiología , Aptitud Física/fisiología , Adulto Joven , Adulto , Niño , Ejercicio Físico , Europa (Continente)/epidemiología , Dieta/estadística & datos numéricos , Dieta/métodos , Factores de Riesgo de Enfermedad Cardiaca , Estado Nutricional , Factores de Riesgo , Estilo de Vida Saludable , Estudios de CohortesRESUMEN
INTRODUCTION: Food intake biomarkers are used to estimate dietary exposure; however, selecting a single biomarker to evaluate a specific dietary component is difficult due to the overlap of diverse compounds from different foods. Therefore, combining two or more biomarkers can increase the sensitivity and specificity of food intake estimates. OBJECTIVE: This study aimed to evaluate the ability of metabolite panels to distinguish between self-reported fruit consumers and non-consumers among participants in the Longitudinal Study of Adult Health. MATERIALS AND METHODS: A total of 93 healthy adults of both sexes were selected from the Longitudinal Study of Adult Health. A 24-h dietary recall was obtained using the computer-assisted 24-h food recall GloboDiet software, and 24-h urine samples were collected from each participant. Metabolites were identified in urine using liquid chromatography coupled with high-resolution mass spectrometry by comparing their exact mass and fragmentation patterns using free-access databases. Multivariate receiver operating characteristic curve (ROC) analysis and partial least squares discriminant analysis were used to verify the ability of the metabolite combination to classify daily and non-daily fruit consumers. Fruit intake was identified using a 24 h dietary recall (24 h-DR). RESULTS: Bananas, grapes, and oranges are included in the summary. The panel of biomarkers exhibited an area under the curve (AUC) > 0.6 (Orange AUC = 0.665; Grape AUC = 0.622; Bananas AUC = 0.602; All fruits AUC = 0.679; Citrus AUC = 0.693) and variable importance projection score > 1.0, and these were useful for assessing the sensitivity and predictability of food intake in our population. CONCLUSION: A panel of metabolites was able to classify self-reported fruit consumers with strong predictive power and high specificity and sensitivity values except for banana and total fruit intake.
Asunto(s)
Biomarcadores , Frutas , Metabolómica , Humanos , Femenino , Masculino , Biomarcadores/orina , Frutas/metabolismo , Frutas/química , Metabolómica/métodos , Persona de Mediana Edad , Adulto , Estudios Longitudinales , Brasil , Dieta , Anciano , Cromatografía Liquida/métodosRESUMEN
The EAT-Lancet Commission proposed a planetary health diet to improve human health within planetary boundaries; however, little is known about the association between adherence to this diet and cognitive decline. We used data from three waves of the Brazilian Longitudinal Study of Adult Health to evaluate the association between the planetary health diet and cognitive decline using linear mixed-effects models. Here we show that in 11,737 participants (mean (s.d.) age 51.6 (9.0) years, 54% women and 53% white), higher adherence to the planetary health diet was associated with slower memory decline (P = 0.046) and that income was a modifier in this association (P < 0.001). Adherence to the planetary health diet was associated with slower decline of memory (P = 0.040) and global cognition (P = 0.009) in high-income participants. No association was found among low-income participants. The results of our study highlight that the promotion of healthy dietary patterns should take into consideration income barriers as well as differences in dietary habits to achieve high adherence.
RESUMEN
BACKGROUND: The EAT-Lancet Commission proposed a global reference diet to promote healthy diets within planetary boundaries. Studies evaluating the associations between the reference diet with health outcomes among adolescents are scarce. Thus, our aim was to assess the association between adherence to the EAT-Lancet diet and cardiovascular health among European adolescents. METHODS: Data from the HELENA study were used. Usual dietary intake was assessed using two 24-h dietary recalls and adherence to the EAT-Lancet diet was assessed using the Planetary Health Diet Index (PHDI), a 16-component index that ranges from 0 to 150 points. Cardiovascular health was assessed through the seven-component Ideal Cardiovascular Health (ICH) score: never smoked, eutrophic body mass index, moderate-to-vigorous physical activity, healthy dietary pattern, low blood pressure, low fasting plasma glucose, and low total cholesterol. Total ICH score was categorized into ideal (5-7) and non-ideal (0-4). RESULTS: A 10-point increment in the PHDI was associated with a lower probability of a non-ideal ICH status (OR 0.84, [95% CI: 0.75, 0.94]) among European adolescents, after adjusting for age, sex, socio-economic status, and total energy intake. Furthermore, a 10-point increment in the PHDI was associated with lower probability of high blood pressure (OR: 0.87 [0.79, 0.96]) and a lower probability of high blood cholesterol (OR: 0.88 [0.78, 0.99]). CONCLUSION: Our study suggests that a higher PHDI may be associated with a better cardiovascular health status among European adolescents.
Asunto(s)
Dieta , Ingestión de Energía , Humanos , Adolescente , Índice de Masa Corporal , Dieta Saludable , ColesterolRESUMEN
Introdução: Índices de avaliação da dieta são instrumentos úteis para identificar a qualidade global da dieta e verificar se a adesão às recomendações dietéticas possui efeitos benéficos na saúde. Em 2019, a Comissão EAT-Lancet propôs um modelo de dieta sustentável, enquanto que a American Heart Association (AHA) possui recomendações dietéticas para promoção da saúde cardiovascular. No entanto, não existem índices baseados nestas recomendações. Objetivo: Desenvolver e validar dois índices de avaliação da dieta baseados na dieta sustentável do EAT-Lancet e nas recomendações dietéticas da AHA e sua aplicação na análise de associação com aterosclerose subclínica. Métodos: Foram utilizados dados do Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil), uma coorte multicêntrica que acompanha 15.105 funcionários de seis instituições públicas de ensino e pesquisa. O consumo alimentar foi avaliado através de um Questionário de Frequência Alimentar (QFA). A aterosclerose subclínica foi avaliada através do escore de calcificação arterial coronariano (CAC) na linha de base (2008-2010) e na segunda onda (2012-2014) e a espessura médio-intimal das carótidas (IMT) na linha de base e na terceira onda (2017-2019). Para o desenvolvimento do Planetary Health Diet Index (PHDI), foram utilizadas as recomendações da Comissão EAT-Lancet e para o desenvolvimento do Cardiovascular Health Diet Index (CHDI), foram utilizadas as recomendações dietéticas da American Heart Association. Após o desenvolvimento dos índices, técnicas de validade e confiabilidade interna foram empregadas. Para avaliar os fatores associados aos índices, foram empregados modelos de regressão linear simples e múltiplos. Modelos de Poisson com variância robusta foram construídos para avaliar a associação entre os índices e a incidência e progressão do CAC, enquanto modelos lineares mistos foram construídos para avaliar os índices e as mudanças no IMT. Resultados: A população apresentou uma média de 60,4 pontos no PHDI (de uma variação possível de 0 - 150 pontos) e de 57,1 pontos no CHDI (de uma variação possível de 0 - 110 pontos). Análises de validade relativa e confiabilidade demonstraram que ambos os índices possuem desempenho satisfatórios, demonstrando boa validade e confiabilidade interna. Observou-se que as mulheres, os idosos, pessoas com maior renda per capita, prática de atividade física moderada e vigorosa apresentaram, em média, maiores pontuações. Ao passo que, os fumantes e as pessoas com sobrepeso e obesidade apresentaram, em média, menores pontuações em ambos os índices. Não foram observadas associações significantes entre o PHDI com CAC e IMT. No entanto, após um período médio de acompanhamento de 8 anos, um aumento de 10 pontos no CHDI foi associado a uma diminuição de 0,0023 mm (IC 95% -0,0045; -0,0002) no IMT. Nenhuma associação foi observada entre o escore CHDI e a incidência e progressão de CAC após um período de acompanhamento de 4 anos. Conclusões: Os resultados demonstram a validade dos índices propostos como ferramentas adequadas para avaliação da dieta. Foi possível observar que a adesão as recomendações de dieta sustentável e promotoras da saúde cardiovascular estão associadas com condições sociodemográficas e de estilo de vida. Além disso, maior adesão à uma dieta cardioprotetora está inversamente associada com um marcador de aterosclerose subclínica.
Introduction: Dietary indices are useful tools to identify the overall dietary quality and to verify whether adherence to dietary recommendations has beneficial effects on health. In 2019, the EAT-Lancet Commission proposed a sustainable diet model, while the American Heart Association (AHA) has dietary recommendations for promoting cardiovascular health. However, there are no indices based on these recommendations. Objective: To develop and validate two dietary indices based on the EAT-Lancet sustainable diet and AHA dietary recommendations and their application in analyzing associations with subclinical atherosclerosis. Methods: Data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), a multicenter cohort following 15,105 employees from six public teaching and research institutions, were used. Dietary intake was assessed through a Food Frequency Questionnaire (FFQ). Subclinical atherosclerosis was assessed through coronary artery calcification score (CAC) at baseline (2008-2010) and the second wave (2012-2014) and carotid intima media thickness (IMT) at baseline and the third wave (2017-2019). For the development of the Planetary Health Diet Index (PHDI), the recommendations of the EAT-Lancet Commission were used, and for the development of the Cardiovascular Health Diet Index (CHDI), the dietary recommendations of the American Heart Association were used. After index development, techniques of validity and internal reliability were employed. To assess factors associated with the indices, simple and multiple linear regression models were used. Poisson models with robust variance were constructed to assess the association between the indices and the incidence and progression of CAC, while mixed linear models were constructed to assess the indices and changes in IMT. Results: The population had a mean score of 60.4 points on the PHDI (out of a possible range of 0-150 points) and 57.1 points on the CHDI (out of a possible range of 0-110 points). Relative validity and reliability analyses demonstrated that both indices performed satisfactorily, showing good internal validity and reliability. It was observed that women, the elderly, individuals with higher per capita income, moderate and vigorous physical activity, on average, had higher scores. Conversely, smokers and overweight and obese individuals, on average, had lower scores on both indices. No significant associations were observed between the PHDI and CAC and IMT. However, after a mean follow-up period of 8 years, a 10-point increase in the CHDI was associated with a decrease of 0.0023 mm (95% CI -0.0045; -0.0002) in IMT. No association was observed between the CHDI score and the incidence and progression of CAC after a 4-year follow-up period. Conclusions: The results demonstrate the validity of the proposed indices as suitable tools for dietary assessment. It was possible to observe that adherence to sustainable diet and cardiovascular health-promoting recommendations is associated with sociodemographic and lifestyle conditions. Additionally, greater adherence to a cardioprotective diet is inversely associated with a marker of subclinical atherosclerosis.
Asunto(s)
Humanos , Masculino , Femenino , Ingestión de Alimentos , Aterosclerosis , Conducta Alimentaria , Enfermedades Cardiovasculares , Estudios Longitudinales , Dieta SaludableRESUMEN
PURPOSE: The EAT-Lancet Commission proposed an evidence-based global reference diet to improve human health within planetary boundaries. Recently, the Planetary Health Diet Index (PHDI) was developed based on the EAT-Lancet recommendations and validated among Brazilian adults. However, the relative validity of the PHDI in adolescents has yet to be assessed. Thus, we aimed to evaluate the relative validity of the PHDI in European adolescents. METHODS: We used cross-sectional data from 1804 adolescents (12.5-17.5 years) enrolled in the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study. The PHDI (0-150 points) was calculated based on dietary intake data from two non-consecutive 24-h dietary recalls. Associations between the PHDI and usual nutrient intakes, plasma food consumption biomarkers, and adherence to the Mediterranean diet were evaluated using multivariable-adjusted mixed-effects linear regression models. RESULTS: Higher PHDI score was associated with greater intakes of nutrients predominantly from plant-source foods, such as vegetable protein, vitamin E, and folate and with lower intake of nutrients predominately from animal-source foods, such as total and saturated fat, cholesterol, and animal protein. Furthermore, a higher PHDI score was also positively associated with plasma ß-carotene, vitamin C, vitamin D, folate, and ferritin concentrations, while negatively associated with trans-fatty acids concentration. Moreover, higher PHDI was related to a greater adherence to the Mediterranean dietary pattern. CONCLUSIONS: The PHDI showed good relative validity among adolescents in the HELENA study. Hence, future research should assess adherence to the PHDI and long-term health outcomes.
Asunto(s)
Dieta Mediterránea , Animales , Adolescente , Humanos , Estudios Transversales , Ingestión de Alimentos , Dieta , Estilo de Vida Saludable , Ácido Fólico , BiomarcadoresRESUMEN
Objective: this study aimed to evaluate if there is an association of intake of coffee and its polyphenols with mammographic findings in women treated at a breast care service unit of the Unified Health System (SUS), Brazil. Research methods and procedures: this was a cross-sectional study with 532 women treated at a health service. The participants were divided according to their mammographic reports into two groups: without and with altered findings. Two 24-h dietary recalls were applied and coffee consumption was categorized into three groups (less than 1 cup, 1 to 3 cups, and more than 3 cups). Phenolic acids were determined using the Phenol Explorer program. The intake of polyphenols was calculated by adding the values obtained from the total amount of coffee consumed during the day. The Multiple Source Method (MSM) was applied to analyze the usual intake. Results: of the 532 women, 178 (33.5 %) had altered mammographic findings. The participants' average daily coffee intake was 193.4 mL. No significant association was found between coffee consumption and mammographic findings. However, it was found that the second tertile of polyphenols was a protective factor for breast changes. Conclusion: Coffee polyphenols are protective against breast changes in the group evaluated and, thus, can help prevent breast cancer. (AU)
Objetivo: este estudio tuvo como objetivo evaluar si existe una asociación de la ingesta de café y sus polifenoles con los hallazgos mamográficos de mujeres tratadas en una unidad de patología mamaria del Sistema Unificado de Salud (SUS), Brasil. Métodos y procedimientos de investigación: este fue un estudio transversal con 532 mujeres tratadas en un servicio de salud. Las participantes se dividieron de acuerdo con sus informes mamográficos en dos grupos: sin y con hallazgos alterados. Se aplicaron dos registros dietéticos de 24 horas y el consumo de café se clasificó en tres grupos (menos de 1 taza, 1 a 3 tazas y más de 3 tazas). Los ácidos fenólicos se determinaron utilizando el programa Phenol Explorer. La ingesta de polifenoles se calculó sumando los valores obtenidos de la cantidad total de café consumido durante el día. Se aplicó el método de fuentes múltiples (MSM) para analizar la ingesta habitual. Resultados: de las 532 mujeres, 178 (33,5 %) tenían hallazgos mamográficos alterados. La ingesta diaria promedio de café de los participantes fue de 193,4 ml. No se encontró una asociación significativa entre el consumo de café y los hallazgos mamográficos. Sin embargo, se encontró que el segundo tercil de polifenoles era un factor protector para los cambios mamarios. Conclusión: los polifenoles del café son protectores contra los cambios mamarios en el grupo evaluado y, por lo tanto, podrían ayudar a prevenir el cáncer de mama. (AU)
Asunto(s)
Humanos , Femenino , Adulto Joven , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Café , Polifenoles , Estudios Transversales , Brasil , DietaRESUMEN
PURPOSE: We aimed to perform a cross-sectional evaluation of the association between dietary patterns and carotid intima-media thickness (cIMT), using baseline data from the Brazilian Longitudinal Study of Adult Health. METHODS: The participants with measurement of the cIMT were included (n = 9,624). cIMT was evaluated in a continuous way and categorized as < 75th and ≥ 75th and ≤ 0.9 mm and > 0.9 mm. Dietary patterns (DPs) were identified by principal component factor analysis. Linear and logistic regression models were used to evaluate the association between cIMT and DPs. RESULTS: Three DPs were derived. For each unit increase in the convenience DP score, the odds for cIMT ≥ 75th increased by 13% (OR 1.13; 95% CI 1.05: 1.22) and for cIMT > 0.9 mm increased by 14% (OR 1.14; 95% CI 1.07: 1.22) in the fully adjusted model. In contrast, each unit increase in the prudent DP score decreased by 8% the odds of having cIMT ≥ 75th (OR 0.92; 95% CI 0.86: 0.98) and by 11% of cIMT > 0.9 mm (OR 0.89; 95% CI 0.84: 0.95). Furthermore, each increase in the convenience DP score was associated with increase in the cIMT (ß 0.01; 95% CI 0.01: 0.02), while each increase in the prudent DP score was associated with decrease in the cIMT (ß -0.01; -0.01; -0.01) in linear regression models. CONCLUSIONS: Our results demonstrate that those individuals with adherence to the convenience dietary pattern are more likely to have high cIMT, while those with adherence to a prudent dietary pattern have lower odds for this characteristic.
Asunto(s)
Grosor Intima-Media Carotídeo , Adulto , Humanos , Estudios Longitudinales , Factores de Riesgo , Estudios Transversales , Brasil/epidemiologíaRESUMEN
Introduction: Objective: this study aimed to evaluate if there is an association of intake of coffee and its polyphenols with mammographic findings in women treated at a breast care service unit of the Unified Health System (SUS), Brazil. Research methods and procedures: this was a cross-sectional study with 532 women treated at a health service. The participants were divided according to their mammographic reports into two groups: without and with altered findings. Two 24-h dietary recalls were applied and coffee consumption was categorized into three groups (less than 1 cup, 1 to 3 cups, and more than 3 cups). Phenolic acids were determined using the Phenol Explorer program. The intake of polyphenols was calculated by adding the values obtained from the total amount of coffee consumed during the day. The Multiple Source Method (MSM) was applied to analyze the usual intake. Results: of the 532 women, 178 (33.5 %) had altered mammographic findings. The participants' average daily coffee intake was 193.4 mL. No significant association was found between coffee consumption and mammographic findings. However, it was found that the second tertile of polyphenols was a protective factor for breast changes. Conclusion: Coffee polyphenols are protective against breast changes in the group evaluated and, thus, can help prevent breast cancer.
Introducción: Objetivo: este estudio tuvo como objetivo evaluar si existe una asociación de la ingesta de café y sus polifenoles con los hallazgos mamográficos de mujeres tratadas en una unidad de patología mamaria del Sistema Unificado de Salud (SUS), Brasil. Métodos y procedimientos de investigación: este fue un estudio transversal con 532 mujeres tratadas en un servicio de salud. Las participantes se dividieron de acuerdo con sus informes mamográficos en dos grupos: sin y con hallazgos alterados. Se aplicaron dos registros dietéticos de 24 horas y el consumo de café se clasificó en tres grupos (menos de 1 taza, 1 a 3 tazas y más de 3 tazas). Los ácidos fenólicos se determinaron utilizando el programa Phenol Explorer. La ingesta de polifenoles se calculó sumando los valores obtenidos de la cantidad total de café consumido durante el día. Se aplicó el método de fuentes múltiples (MSM) para analizar la ingesta habitual. Resultados: de las 532 mujeres, 178 (33,5 %) tenían hallazgos mamográficos alterados. La ingesta diaria promedio de café de los participantes fue de 193,4 ml. No se encontró una asociación significativa entre el consumo de café y los hallazgos mamográficos. Sin embargo, se encontró que el segundo tercil de polifenoles era un factor protector para los cambios mamarios. Conclusión: los polifenoles del café son protectores contra los cambios mamarios en el grupo evaluado y, por lo tanto, podrían ayudar a prevenir el cáncer de mama.
Asunto(s)
Café , Polifenoles , Humanos , Femenino , Brasil , Estudios Transversales , DietaRESUMEN
PURPOSE: The EAT-Lancet Commission released a reference sustainable diet to improve human health and respect the planetary boundaries. The Planetary Health Diet Index (PHDI) was developed with the purpose of evaluate the adherence to this reference diet. The aim of the present study was to evaluate the association between adherence to the EAT-Lancet diet with cardiometabolic risk profile. METHODS: We used the cross-sectional baseline data from 14,155 participants of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), a multicenter ongoing cohort study. Dietary data were collected using a 114-item validated food frequency questionnaire. The PHDI was used to assess the adherence to the EAT-Lancet diet. It consists of 16 components and the total score can range from 0 to 150 points. Linear, logistic and quasi-Poisson regression models were built to evaluate the associations between PHDI and the outcomes. RESULTS: Individuals with higher adherence to EAT-Lancet diet (PHDI, 5th quintile) had lower values for systolic blood pressure (ß - 0.84; 95% CI - 1.66: - 0.01), diastolic blood pressure (ß - 0.70; 95% CI - 1.24: - 0.15), total cholesterol (ß - 3.15; 95% CI - 5.30: - 1.01), LDL-c (ß - 4.10; 95% CI - 5.97: - 2.23), and non-HDL-cholesterol (ß - 2.57; 95% CI - 4.62: - 0.52). No association was observed for HDL-c, triglycerides and HOMA-IR. CONCLUSIONS: Our results indicate that higher adherence to the EAT-Lancet diet is associated with lower levels of blood pressure, total cholesterol, LDL-c, and non-HDL-c.
Asunto(s)
Enfermedades Cardiovasculares , Dieta , Adulto , Humanos , Estudios de Cohortes , Estudios Longitudinales , Brasil , Estudios Transversales , Colesterol , Factores de RiesgoRESUMEN
BACKGROUND: Advances in technology have led to the identification of a greater number of metabolites related to diet. Although fruit intake biomarkers have been reported in some studies, these findings require further replication, considering the relevance of fruits for diet quality and health. OBJECTIVES: The aim of this study was to explore the associations of a set of potential urinary biomarkers of diet, assessed using a targeted metabolomics approach, with self-reported fruit intake data in participants of a computer-assisted 24-h dietary recall (GloboDiet software) validation study. METHODS: A total of 93 individuals aged 43-72 y, 54% female, participated in this study. The subjects were a subsample of the Longitudinal Study of Adult Health (ELSA-Brasil). A 24-h dietary recall was obtained with the aid of GloboDiet software matching a 24-h urine sample from each participant. Candidate biomarkers were selected in a literature search and identified in urine by LC coupled to high-resolution MS. Spearman correlation analyses were performed between fruit intake and each biomarker. RESULTS: Spearman correlation analysis showed that total fruits intake was significantly correlated with citric acid (ρ = 0.213, P = 0.041), ferulic acid sulfate I (ρ = 0.240, P = 0.020), hesperetin glucuronide/homoeriodictyol glucuronide (ρ = 0.303, P = 0.003), hydroxyhippuric acid (ρ = 0.239, P = 0.021), homovanillic alcohol sulfate (ρ = 0.339, P = 0.001), methylgallic acid sulfate (ρ = 0.268, P = 0.009), naringenin glucuronide (NG; ρ = 0.278, P = 0.007), proline betaine (PB; ρ = 0.305, P = 0.003), syringic acid sulfate (ρ = 0.210, P = 0.044), and sinapic acid sulfate (ρ = 0.412, P < 0.001). Among them, 3 have been described in literature as promising biomarkers for intake of total fruit, oranges, and citrus fruit: NG, hesperetin glucuronide, and PB. CONCLUSIONS: Associations of total fruits intake with urinary measurements indicate the potential usefulness of dietary biomarkers in the Brazilian population as a complement to self-reported dietary assessments.
Asunto(s)
Frutas , Glucurónidos , Biomarcadores/orina , Brasil , Estudios Transversales , Dieta , Femenino , Humanos , Estudios Longitudinales , Masculino , Metabolómica , SulfatosRESUMEN
The American Heart Association (AHA) has developed the concept of "ideal cardiovascular health" (ICH), a seven-component score, which includes health dietary metrics. Higher ultra-processed foods intake is related with several cardiometabolic and cardiovascular diseases. We propose to develop and validate the Cardiovascular Health Diet Index (CHDI), a diet quality index that combines the AHA's recommendations of a healthy diet for cardiovascular health and ultra-processed foods. We used dietary data obtained through a 114-item FFQ from 14,779 participants of the Brazilian Longitudinal Study of Adults Health (ELSA-Brasil). The CHDI had 11 components and a total score ranging from 0 to 110 points. Validation and reliability analyses were performed, including principal component analyses, association with selected nutrients, means differences between groups (for example, smokers vs. non-smokers), Cronbach's alpha, and linear regression analyses between CHDI and overall dietary quality. The mean CHDI was 57.1 points (95% CI 47.9:66.0). The CHDI had four dimensions; in addition, it was associated with nutrients related to cardiovascular health, and the points were significantly (p < 0.001) lower in smokers (52.1) than in non-smokers (57.8). Cronbach's alpha value was 0.50. After age and sex adjustment, the CHDI score remained associated with a higher overall dietary quality (ß 0.87, 95%CI 0.84:0.89, p < 0.001). The CHDI proved to be valid and reliable for use, in addition to being associated with higher overall dietary quality. The use of CHDI is expected to assess the population's compliance with dietary recommendations for promoting cardiovascular health and preventing cardiovascular disease.
RESUMEN
Introduction: Breast cancer is one of the main types ofcancer in women. Previous studies assessed the relationshipbetween diet and breast cancer risk, however, studies thatevaluate the relationship between diet and mammographicfindings are scarce. Aim: To evaluate the association between dietary patternsand mammographic findings of women monitored by a mas-tology service of the Brazilian Unified Health System. Materials and Methods: Cross-sectional study that eval-uated data from 504 women. Two 24-hour dietary recallswere applied and dietary patterns were identified by principalcomponent factor analysis. The mammography reports wereclassified into normal and altered mammographic findings. Logistic regression models were applied to evaluate the asso-ciation between dietary patterns and mammographic findings.The analyses were performed in the software Stata and R andconsidered significant values of p <0.05. Results: Three dietary patterns was identified: traditionalBrazilian (rice, beans, red meat, breads, oils and fats andcoffees and teas), Western (sugar sweetened beverages, eggs, cakes, pies and cookies, fast-food snacks and, sweetsand desserts) and prudent (whole grains, fruits, vegetables,tubers and their products, dairy and chicken). Women withless adherence (OR 0.54 CI 95% 0.30:0.95) to the traditionalBrazilian dietary pattern had 46% lower odds for having al-tered mammographic findings. No associations were foundbetween Western and prudent dietary patterns with mam-mographic findings.(AU)
Asunto(s)
Humanos , Femenino , Neoplasias de la Mama , Dieta , Mamografía , Registros de Dieta , Brasil , 52503 , Estudios TransversalesRESUMEN
Introduction: Introduction: inadequate consumption of micronutrients is an emerging public health problem that can compromise health. Objectives: to assess whether the quality of dietary carbohydrates is associated with the consumption of 13 micronutrients in a sample of women monitored by the Brazilian Unified Health System. Methods: this cross-sectional study included 648 women monitored by the Brazilian Unified Health System. The association between quality of dietary carbohydrates and adequacy of consumption of 13 micronutrients was investigated using logistic regression models adjusted for potential confounding variables. Results: the consumption of micronutrients increased as the quality of carbohydrates improved. The micronutrients with the highest prevalence of inadequate intake were vitamin A, magnesium, manganese, and thiamine. After adjustments using logistic regression models, women in the third tertile of the carbohydrate quality index were less likely to have an inadequate consumption of magnesium (odds ratio (OR), 0.29; 95 % confidence interval (CI), 0.14-0.59), manganese (OR, 0.32; 95% CI, 0.21-0.49), and copper (OR, 0.22; 95% CI, 0.12-0.37). Conclusions: intake of a higher quality of dietary carbohydrates is associated with improved adequacy in consumption of most micronutrients in women monitored by the Brazilian Unified Health System, especially magnesium, manganese, and copper, after adjustment using regression models.
Introducción: Introducción: el consumo inadecuado de micronutrientes es un problema de salud pública emergente que puede comprometer la salud. Objetivo: evaluar si la calidad de los carbohidratos de la dieta está asociada con el consumo de 13 micronutrientes en una muestra de mujeres monitoreadas por el Sistema Único de Salud de Brasil. Métodos: este estudio transversal incluyó a 648 mujeres monitoreadas por el Sistema Único de Salud de Brasil. La asociación entre la calidad de los carbohidratos de la dieta y la adecuación del consumo de 13 micronutrientes se investigó mediante modelos de regresión logística ajustados por posibles variables de confusión. Resultados: el consumo de micronutrientes aumentó a medida que mejoraba la calidad de los carbohidratos. Los micronutrientes con mayor prevalencia de ingesta inadecuada fueron: vitamina A, magnesio, manganeso y tiamina. Después de los ajustes mediante modelos de regresión logística, las mujeres del tercer tercil del índice de calidad de carbohidratos tenían menos probabilidades de tener un consumo inadecuado de magnesio (odds ratio (OR): 0,29; intervalo de confianza (IC) del 95 %: 0,14-0,59), manganeso (OR: 0,32 ; IC del 95 %: 0,21 a 0,49) y cobre (OR: 0,22; IC del 95 %: 0,12 a 0,37). Conclusiones: la ingesta de una mayor calidad de carbohidratos en la dieta se asocia con una mejor adecuación en el consumo de la mayoría de los micronutrientes en mujeres monitoreadas por el Sistema Único de Salud de Brasil, especialmente magnesio, manganeso y cobre, después del ajuste mediante modelos de regresión.
Asunto(s)
Micronutrientes , Oligoelementos , Brasil/epidemiología , Cobre , Estudios Transversales , Dieta , Carbohidratos de la Dieta , Femenino , Humanos , Magnesio , ManganesoRESUMEN
Diets are simultaneously connected with population health and environment. The EAT-Lancet Commission proposed a sustainable reference diet to improve population health and respect the planetary boundaries. Recently, the Planetary Health Diet Index (PHDI) has been developed to assess the adherence to this reference diet. In the present study, we aimed to evaluate the adherence to the EAT-Lancet diet through the PHDI in a nationwide population-based study carried out in Brazil. We used data from the National Dietary Survey conducted through the Household Budget Survey in 2017-2018, with 46,164 Brazilians aged over 10 years old. Food consumption was evaluated with a 24 h dietary recall. The average PHDI total score in the Brazilian population was 45.9 points (95% CI 45.6:46.1) on a total score that can range from 0 to 150 points. The adherence to EAT-Lancet diet was low among all Brazilian regions. Women, elderly, those overweighed/obese, with higher per capita income and living in the urban area had higher scores in the PHDI. In general, the Brazilian population presented low adherence to a healthy and sustainable dietary pattern and seems far from meeting the EAT-Lancet recommendations.
Asunto(s)
Dieta , Renta , Anciano , Brasil , Niño , Encuestas sobre Dietas , Dieta Saludable , Femenino , HumanosRESUMEN
INTRODUCTION: There are gaps in knowledge in breast cancer prevention studies focusing on interactions among mammographic findings, inflammation, and diet, especially those related to carbohydrates. OBJECTIVE: We aimed to verify the association among mammographic findings, inflammatory markers, and carbohydrate quality index (CQI) in women. METHODOLOGY: This was a cross-sectional study of 532 women assisted in a healthcare service. The enrolled women were divided into two groups according to their mammographic findings: those without and those with abnormal mammographic findings. Two 24-hour dietary reminders were applied, and CQI was determined based on four components: fibers, glycemic index, ratio between whole and total grains, and ratio between solid and total carbohydrates. The neutrophil-to-lymphocyte ratio (NLR) was calculated as an inflammatory marker. RESULTS: There were 178 (33.5%) women with abnormal mammographic findings, and 20 (3.8%) had NLR. There was no association between CQI and mammographic findings and NLR. Women with abnormal mammographic findings and high NLR had lower CQI (p = 0.039) and lower whole total ratio (p = 0.024). CONCLUSION: Women with abnormal findings and high NLR had worse CQI and worse overall total grain ratio.
Asunto(s)
Carbohidratos de la Dieta , Neutrófilos , Estudios Transversales , Femenino , Índice Glucémico , Humanos , Linfocitos , MasculinoRESUMEN
Obesity in children and adolescents is a public health problem and diet can play a major role in this condition. We aimed to identify sex-specific dietary patterns (DP) and to evaluate the association with overweight/obesity in European adolescents. We conducted a cross-sectional analysis with 2327 adolescents aged between 12.5 to 17.5 years from a multicenter study across Europe. The body mass index was categorized in "normal weight" and "overweight/obesity". Two non-consecutive 24-h dietary recalls were collected with a computerized self-reported software. Principal component factor analysis was used to identify DP. Mixed-effect logistic regression models were used to evaluate the association between the sex-specific DP and overweight/obesity outcome. As a result, we found three DP in boys (snacking and bread, Mediterranean diet, and breakfast) and four DP in girls (convenience, plant-based and eggs, Western, and breakfast). The association between DP and overweight/obesity highlights that those adolescents with higher adherence to the breakfast DP had lower odds for overweight/obesity, even after the inclusion of covariables in the adjustments. In European adolescents, the breakfast DP positively characterized by breakfast cereals, fruit, milk, and dairy and negatively characterized by sugar-sweetened beverages in boys and negatively characterized by cereals (pasta, rice, and others) in girls, was inversely associated with overweight/obesity.
RESUMEN
The EAT-Lancet Commission has proposed a model diet to improve the health of human beings and that of the planet. Recently, we proposed the Planetary Health Diet Index (PHDI) to assess adherence of the population to this model diet. In this study, we aimed to evaluate adherence to the PHDI and obesity outcomes using baseline data from 14,515 participants in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). The dietary data were assessed using a 114-item FFQ. Body mass index (BMI) and waist circumference (WC) were both used continuously and categorized. Linear and multinomial regression models adjusted for potential confounding factors were performed to assess the relationship between adherence to PHDI and outcomes. An inverse association was observed between adherence to PHDI and obesity indicators. Individuals with high adherence to the PHDI had lower BMI (ß-0.50 95% CI-0.73:-0.27) and WC (ß-1.70 95% CI-2.28:-1.12) values. They were also 24% less likely to be overweight (OR 0.76 95% CI 0.67:0.85) or obese (OR 0.76 95% CI 0.65:0.88), and they were 14% and 27% less likely to have increased WC (OR 0.86 95% CI 0.75:0.98) or substantially increased WC (OR 0.73 95% CI 0.64:0.83) than those with lower adherence. Our results showed that higher adherence to the PHDI may decrease obesity indicators.
Asunto(s)
Dieta Saludable/estadística & datos numéricos , Adhesión a Directriz/estadística & datos numéricos , Política Nutricional , Obesidad/epidemiología , Obesidad/prevención & control , Adulto , Anciano , Anciano de 80 o más Años , Índice de Masa Corporal , Brasil/epidemiología , Estudios Transversales , Encuestas sobre Dietas , Dieta Saludable/normas , Femenino , Salud Global/normas , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Análisis de Regresión , Circunferencia de la CinturaRESUMEN
The EAT-Lancet Commission has proposed a planetary health diet. We propose the development of the Planetary Health Diet Index (PHDI) based on this proposed reference diet. We used baseline dietary data obtained through a 114-item FFQ from 14,779 participants of the Longitudinal Study on Adult Health, a multicenter cohort study conducted in Brazil. The PHDI has 16 components and a score from 0 to 150 points. Validation and reliability analyses were performed, including principal component analyses, association with selected nutrients, differences in means between groups (for example, smokers vs. non-smokers), correlations between components and total energy intake, Cronbach's alpha, item-item correlations, and linear regression analysis between PHDI with carbon footprint and overall dietary quality. The mean PHDI was 60.4 (95% CI 60.2:60.5). The PHDI had six dimensions, was associated in an expected direction with the selected nutrients and was significantly (p < 0.001) lower in smokers (59.0) than in non-smokers (60.6). Cronbach's alpha value was 0.51. All correlations between components were low, as well as between components and PHDI with total energy intake. After adjustment for age and sex, the PHDI score remained associated (p < 0.001) with a higher overall dietary quality and lower carbon footprint. Thus, we confirmed the PHDI validity and reliability.